In 1891 American physician George Wells Fitz (1860-1934) started an exercise physiology laboratory at Harvard University and in 1908 he published 'Principles of Physiology and Hygiene'.
Viennese masseur Johann Lovranics developed this device shown above under the motto 'Gymnastik erhält Gesundheit und Schönheit', (Gymnastics maintains health and beauty) which he patented.
Due to a lack of recognition and university education, massage and physiotherapy were neglected by hospital physicians. They did not consider this as a specialization or an empirical addition of conventional medicine. Without control, indications or dosage forms, the medical faculties could not develop therapy for the various institutions. In 1908, the speakers of the '1er Congrès de Physiothérapie des médecins de langue française' (1st Physiotherapy Congress of the Physicians of the French language) tried to demonstrate in Paris the effects of different physiotherapy methods and communicated the results of their comparative experiments with conventional therapies, to provide credibility for these new technologies to the medical university world.
At the 1908 Olympics in London, German Arthur Mallwitz (1880-1968) competed in the standing high jump and the standing long jump, but at the same time he was also the sports doctor of the German team. However, no medical cabinets were provided in London and only the marathon runners had to undergo medical examination before their race. Mallwitz also published his thesis 'Körperliche Höchstleistung mit besonderer Berücksichtigung des Olympischen Sportes' (Maximum physical performance with special consideration of the Olympic sport), which is labeled as the very first thesis on Sports Medicine.
American cyclist Robert Waltour (1878-1949), who was world champion stayer twice and excelled in six days, was a staunch supporter of massage during competitions.
Alfred Schanz (1868-1931) was a German orthopedist, who pleaded for massage treatments in his book 'Handbuch der Orthopädischen Technik für Ärzte und Bandagisten'. Schanz introduced the term 'functional insufficiency'.